Father Kawas François, a Haitian Jesuit priest, sighs deeply when asked about the 300,000 people still living in tents three years after an earthquake ripped through his country.

The disaster killed between 230,000 and 300,000 people in what was already the western hemisphere's poorest state, and made 1.5 million people homeless. For Father Kawas, who co-ordinated emergency response efforts in 2010 (video), several reasons lie behind the continued existence of tent cities where people swelter during the day and are soaked by evening rains.

But the main one is the government's inability to acquire land from powerful families around the capital. "I think it's difficult to rehouse these people because most of the land surrounding Port-au-Prince belongs to very powerful families and those families don't want to give the land to the state to rehouse people. It's a very big problem because those families are very powerful and they have many political resources so they can influence the decisions of the state."

In 2008, it was struck by four deadly storms – Fay, Gustav, Hannah and Ike – that killed 800 people and devastated 70% of the agricultural land. As it was still picking up the pieces after the earthquake on 12 January 2010, Haiti was hit by hurricane Sandy last November.

Poverty was cited by Father Kawas as another reason why so many people remain homeless. "They don't have enough money to rent a house, or to rebuild a house," he says. "It is difficult for them because most of them don't work, they have no jobs. NGOs cannot do everything. They cannot rehouse all the people in Haiti."

Haiti's earthquake prompted a large response from governments and NGOs worldwide. Three years on, aid agencies trumpet their efforts. The EU, which has spent 85% of the €522m (£425m) funds it promised to send to Haiti, said its aid had provided more than 500,000 people with housing and supported the treatment of cholera – an outbreak widely blamed on Nepalese UN troops. About 6% of the population have been infected and more than 7,500 people have died – a higher toll than the political instability that brought the peacekeepers to Haiti in 2004.

The Red Cross and Red Crescent launched their biggest single country response in the immediate aftermath of the earthquake, sending 21 emergency teams to provide food, water, shelter and healthcare, and providing emergency aid for 1.1 million people. The British Red Cross said it began a second phase of recovery work in July focusing on one neighbourhood in Port-au-Prince, Delmas 19, to provide more in-depth support, from rebuilding basic infrastructure to getting children into school, and increasing the number of small businesses.

Unicef, the UN agency for children, said preliminary results of a national household survey show substantial progress for children in education, nutrition, health and sanitation since 2006.

According to the initial results of the Haiti demographic and health survey (DHS), covering 13,350 households, 77% of children aged 6-11 years attended primary school last year compared with just below 50% in 2005-06. Acute malnutrition among children aged 6-59 months has been reduced to 5% from 10%.

International aid has undoubtedly provided much-needed help. The lack of co-ordination, however, – apparent from the start – persists. "I don't think there is real co-ordination," says Father Kawas. "We have observed a lot of conflict on the ground in Haiti, conflict for example between Venezuelans and French NGOs, between French NGOs and Cubans, between Americans and Cubans in Haiti.

"For example, the Canadian agency for international development – they have a lot of projects in Haiti, but we don't see co-ordination with USAid. Sometimes they do the same work so it's also a real problem for the government. I would like international actors to help the government to have a plan, a national plan of construction."

Haiti's state institutions were fragile even before the earthquake and were weakened by the disaster. The Haitian government has received little in reconstruction funds as foreign governments have had little faith in its ability to handle the relief effort. That the government has yet to draw up a national reconstruction plan speaks volumes.

"The big problem for NGOs and for many actors in Haiti is the lack of a national plan for construction," says Father Kawas. "The government speaks about that but right now, we don't see this plan and we know that this plan is very important for the country, for the development of the country. For example, the NGOs are working separately, in isolation, and there is no co-ordination, there is no plan [from] the government, so for me it's a real problem for the development of the country. And the international organisations do the same."

Father Kawas acknowledges the difficulties in trying to strengthen his government, but urged aid agencies to provide training for public employees, as well as to help parliament and political parties.

"In Haiti, the public administration does not function, it's a real problem. The government cannot put in practice its policies if the public administration does not function so it's a real necessity for foreign governments to help the Haitian government find solutions."